Individual
MISS NIURKA E GRULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOLE PROPRIETARY
Contact information
Practice address
9 ORCHARD ST FL 2, LODI, NJ 07644-3112
(917) 736-0265
Mailing address
9 ORCHARD ST FL 2, LODI, NJ 07644-3112
(917) 736-0265
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
1619498221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K1011146501
DEPARTMENT OF EDUCATION
NY
Enumeration date
11/08/2022
Last updated
11/08/2022
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